Monday, March 30, 2009

The Random Bites

While the work load is definitely lighter this semester in terms of pure hours in the school, I can’t help but feel like we have taken a step backwards in terms of dental education. Last semester had me learning how to make dentures, RPDs, provisionals, crown preps, cast-post and cores, not to mention full endodontic therapy. What about this semester? Make way for the active site of COX-1 inhibitors, or how to chart audit. Granted we are learning plenty, but it feels so random and out of sorts.

The implant course has just been an absolute mess in terms of coherence. The lectures are never posted online until several days after the lecture. The problem lies in that these lectures are almost purely picture-based. So you end up with a notebook page full of random notes trying to remember what picture each note applies to once you finally can download the lecture. Don’t even get me started on the absurdity of the quizzes either. The only saving grace for this course is that the lab sessions are generally helpful…but we only have four all semester.

The clinical exposure has been good overall, but as previous posts point out – we just don’t get enough consistent time. Not to mention most of the instructors fail to realize that we are second year students with minimal experience in the clinics. Of course our rotation schedule for the summer probably won’t be finished until a week before we start – so we can’t exactly start booking chairs.

The most annoying part of this semester though is the random annoying assignments. You know, the ‘let’s write up a boring paper based on a poster you read at some meeting’ sort of assignment. I am looking at this list of papers/presentations and here are a few examples:

Patient portfolio - 10-15ish page paper pretty much describing your first complete work-up of a patient prior to treatment planning.

Business report – I have asked about 10 of my classmates, we don’t even remember what this is or when we have to do it.

Attendance papers – basically had to write two papers on random topics to prove we attended two separate functions

Communications reflection – 3 page paper reflecting about your communication skills (had to tape-record yourself talking to a patient).

Chart audit – still haven’t had this yet

Endo case presentation – present diagnostic case in front of endo faculty (power point format)

EBD paper for tx planning – 5 page paper about random EBD topic assigned to your group

EBD paper for implants – 20 minute presentation about random EBD topic assigned to your group (pp format)

There is more crap I’m sure but I can’t keep going. None of these tasks is particularly challenging or even stimulating to the brain. They just become overwhelming by sheer volume. Like a swarm of mosquitoes biting at the back of your neck.

I have spent so much time writing random papers and researching various topics that I feel like my limited clinical abilities have atrophied. Last semester was so intensive clinically-speaking that this current semester feels grossly out of place.

Then again, I must also take into account that I may just be completely tired of second year, and am itching to officially become an ‘upperclassman.’

Who knows..but you can expect one final D-2 experience post to sum up this arduous year sometime in May.

Sunday, March 22, 2009

Assisting CRDTS

I assisted a D-4 with her CRDTS exam yesterday which is the regional licensure exam. Basically you MUST pass this exam to legally practice in the state of Illinois (and several other Midwest states). The 4th years just have tons of big exams to take – which leads me to believe that my upcoming third year of dental school really is the big time learning year without the stress of HUGE non-school given exams.

So this CRDTS exam was pretty intense. I arrived at 7:30am and didn’t leave until 5:00pm. There was no lunch break (or even bathroom break for that matter). There just is no time, as the assistant, it is namely my job to keep things running smoothly for the student. Helping to rapidly breakdown and re-bag the chairs between patients, getting/returning instruments from sterilization, walking the patient over to the grading station for evaluation or mod-requests, and so forth.

The ‘candidate,’ as the upperclassman is referred to by the intimidating test administrators, must complete two major blocks – perio and restorative. Perio was straightforward; the patient comes in and needs to have a quadrant scaled. Two teeth are randomly assigned for probing checks. After the start check (and verificaction that calculus exists on the surfaces to be tested), the student gets 90 mins to do the work. Barely finished on time because there was some really stubborn calculus.

The next portion is the restorative portion. You essentially get six hours to complete two procedures – a class III composite and a class II amalgam. Two patients are pretty much required because the odds of finding one with both lesions in perfect position is unlikely. Six hours is a long time right? It goes REALLY fast, and each trip to the grading station (requesting mods, prep grade, final rest grade) takes a good 15 mins.

I could go into details, but that isn’t the point – I learned a ton, and sort of freaked myself out a bit in the process. Failing this exam is quite common and I saw at least one student get sent home early for missing some decay on the prep. It isn’t the end of the world because you can retake it again in May, but that equates to finding more patients and repeating the entire test which is no good.

The student I assisted made it through the day and only had one evaluator created change (excess flash on the composite). This only docks her some points though, it doesn’t equal an immediate fail. I am taking this exam in two years, but I can already tell it will be the most stressful day of my life.

Now I have one last day of spring break to enjoy before hitting the homestretch (7 more weeks!) of D-2 year.

Wednesday, March 18, 2009

Something To Think About

Remember when you were a little kid and you would go off to visit your grandparents? Be it for Christmas, the 4th of July, Thanksgiving, or a wedding, you invariably ended up staying at Grandma's. Now, think back if you will about the things your grandparent's liked doing..oh I don't the music they had. Old timey stuff that..ya know, you would hear on the old radio. That music had a certain feel, it was grandma music. Pleasant and wholesome.

So now, jump into a mental time table. Imagine this latest generation of early 20ish people. Imagine US as grandparents. Our grandkids are going to come over just like we once did years ago to visit. You know what they are going to hear?

Hoes, Bitches, and Bling Blingin'

...Holy crap.

Two Things

Thing 1: Reading Assignments

Ok, I’m all for learning, I mean I technically am a 20th grader – but I don’t understand some of the philosophies exhibited by our instructors. I mean, these people (for the most part) ALL went to dental school and should remember just exactly how little time you have to casually read 50 pages of journal articles in a single week. Don’t get me wrong, certain TEXT books are great adjuncts to lecture (example = Torabinejad/Walton Endo text). Where I get steamed is all these damn research articles. I weep for the incoming classes if this is how they are expected to learn.

I completely understand the validity of assessing research, but this is not nearly as applicable to learning itself. For example, in our Ortho class, we are commonly assigned 3-5 journal articles to read prior to having the lecture on said topic. Now anyone that has read any sort of scientific journal completely understand how DRY and BORING this type of writing is (UNLESS you are knowledgeable and interested). If I don’t know anything about the physics and biomechanical properties of tooth movement, how can I possibly be expected to cram down 5 journal articles when I have had ZERO exposure to this topic in class? Hell, even if I was in love with ortho, I would have trouble finishing that WHILE managing to not fail all the other assorted classes and busy work they have me doing. It may be just me, but I really can’t get through research based articles without having ANY background about the topic beforehand. I get that we need to learn this stuff, but it can literally take a good hour or two to read one article thoroughly and actually comprehend even when you are familiar with the subject. So when am I going to find an extra 10 hours out of my week to read ortho papers? It simply isn’t going to happen.

Now for an example of how research articles can be used effectively. In our fixed prosthodontics class, articles are used to enhance our learning efficiently, not bog us down. For example, we were given a lecture on pontics earlier this semester – afterwards, we were given two research articles to read with an accompanying question sheet. The questions asked were all found in the articles and relevant to the main points of the lecture. I actually enjoyed reading these articles because we had just been exposed to the topic and I actually could follow the articles coherently without teaching myself everything for the first time. We are often given 1-2 weeks to read these articles and then given a quiz which reflects MANY of the questions already provided. So yea, just two examples on the same philosophy – but one is done well, while the other expects me to read at the same rate as a cyborg.

Thing 2: Dragging grade distribution out

So I just was praising fixed; now I can get pissed at it. This last Wednesday we got our performance exam grades back for our 3-unit bridge provisionals. Only it got dragged out FOREVER. Let me preface this by adding that the grading in this class is VERY tough. Much harder than any other performance exam-based course. I generally do well on PEs but last semester (as rabid fans may recall) failed the first exam and got a 71% on the second. So needless to say, I was a bit stressed out for fear of bombing the third of this gruesome quartet.

8am: We have 1 hour of OS lecture..everyone is thinking…crap..I hope I passed fixed.

9am: Fixed course director comes in, tells us she will get to the exam later – proceeds to lecture about the next project. It is pretty hard to concentrate on the next leg of your academic journey when you still aren’t sure if you survived the last ordeal.

9:30: Director finishes presentation and proceeds to say: “Ok, now for the exams…what was wrong guys? Did you have a bad day? 33 of you failed, that is 50% of the class. You are setting new records in my course, and not the good ones. I am very worried.”

Ok..can we see if we failed yet..NO. She starts showing all these statistics about HOW we did terribly (the failing breakdown if you will).

10:00 – we get into the pre-clinic to start the days project..we don’t have our dentechs because they were being graded

10:15 – still no teachers or dentechs

10:30 – teachers trickle in, dentechs are distributed with NO grades.

10:45 – Some students get grades. I see little dances or looks of utter devastation. The end is near.

11:00 – I FINALLY, FINALLY get my grade. While I did all right in the end, I must have aged about 2 years just waiting.

Point being – PLEASE PLEASE PLEASE GIVE GRADES OUT BEFOREHAND. I honestly cannot focus on anything when I know grades are done, yet I still for some reason can’t see them. The actual percentage really isn’t what keeps me worried, but the fear of having to redo a 3-hour exam is not appealing at all – especially considering how busy things tend to get at the end of the semester.

I would like to add the disclaimer that the instruction in this class is generally pretty damn good. Although the nit-picking can get very frustrating at times, I know in the long run – it will make me better clinically (or at least give me a great eye for when things are not good). I also feel like I finally understand crown preps and how to work with acrylic. I don’t know what happened over winter break, but everything seems much easier. I am not horribly reducing my line angles and I am getting provisionals done faster and faster.

And with the rant out of the way, I shall continue my nice lazy spring break which is barely even 1/2-way over...ahhhhh.

Wednesday, March 4, 2009

Another Batch Finished

I am back for another off-afternoon. We had an oral surgery mid-term this morning, followed by our first fixed performance exam (3 unit-provisional in 3 hours). Seeing as I still have trouble finishing these temps in 3 hours, I really have no idea how I am supposed to cut the preps and make the provisional on a real patient in 2.5 hours (not including seating, anesthetizing, and needing constant check-offs). I suppose my provisionals won’t be graded under such scrutiny by clinical professors though which is the only saving grace.

Needless to say, I was practicing over the weekend and generally finishing on time. I can make a functional temp really fast, but fine-tuning and getting everything to look perfect takes hours. I feel like I passed the exam though (no major mistakes). Unfortunately I will never feel at ease until I see the grade.

So aside from a brutal ortho mid-term, I have been getting through this semester pretty well. Spring break is only one week away, and I am edging nearer and nearer the end of this long D-2 year. I must admit, I am ready to treat patients exclusively. It is a lot more exhaustive, but I get so much more out of patient interaction at this point and now I just want the experience. I was assigned another new patient, but I unfortunately won’t have a solid block of clinic time until April which is frustrating. There really isn’t much I can do about it. They are trying to get us into the clinics, but with all the upperclassmen requiring chairs and all of our lectures/pre-clinic coursework, there just isn’t as much opportunity as I would like.

Things are moving along, the weather is getting warmer, the sun is staying out longer, and winter is beginning to die off (finally). Not much else to say, school has numbed my writing sensibilities so I will leave it as is for now.

Time to write some BS paper and study for pharm.